The use of therapeutic agents for the treatment of ligament, tendon and muscle tissue injury has become increasingly popular as the efficacy for these treatments has become more promising. In addition, the use of percutaneous devices to treat these injuries is highly beneficial for the patient resulting in reduced recovery times, decreased infection rates, improved mobility, and less physical therapy times when compared to traditional reconstruction surgery. As therapeutic agents for treating tendon, ligament and muscle damage progresses, the devices to deliver those agents percutaneously must likewise progress to provide clinicians options to optimally treat their patients.
Tendons, ligaments and muscle provide the mechanical mechanisms and support for the body. Tendons and ligaments are mainly composed of aligned collagenous fibers packaged into bundles. Muscle composition may similarly be bundled into fascicles consisting of aligned myocytes that provide the mechanical energy for movement. Damage to these tissues by means of injury or disease creates serious complications both in the short and long term. In certain tendons, ligaments and muscle the body is limited in repairing the damage based on several factors. For one, the damage may be so extensive that it is beyond repair such as a full thicknesses retracted tear. In other circumstances certain areas of the musculoskeletal system lack vascularity limiting the appropriate immune response for natural healing. To overcome this deficiency, biological agents such as autologous platelet rich plasma, platelet lysate, nucleated cells isolated from the bone marrow or fat, progenitor cells, and mesenchymal or other stem cells percutaneously transplanted to the damaged site have shown in-vitro and in animal studies to aid in the repair process. The localization of therapeutic agents to the damaged site is important to successfully target the tear or lesion. Based on current methods this can be accomplished with great skill under ultrasound or fluoroscopic imaging, however certain anatomical locations are difficult to reach with known techniques.
One such challenge in delivery localization occurs when treating the anterior cruciate ligament (ACL). There is no currently available and published technique for accessing this ligament percutaneously. One option for delivering therapeutic agents to the ACL bundles involves using a needle placed at the interchondylar eminence as verified under fluoroscopic imaging. The ACL emanates from the tibia at this location and this bony landmark provides the clinician with a reference point to treat the tissue. However often times the damaged part of the tissue resides at the proximal region of the ACL where localized delivery would be difficult since there is no fluoroscopic reference point, the delivery needle is normally rigid, and a bent needle or catheter may become misguided to the target.
The following embodiments disclosed herein are directed at overcoming one or more of the problems discussed above.